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2016 ; 27
(6
): 1801-10
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Ergocalciferol Supplementation in Hemodialysis Patients With Vitamin D
Deficiency: A Randomized Clinical Trial
#MMPMID26677862
Miskulin DC
; Majchrzak K
; Tighiouart H
; Muther RS
; Kapoian T
; Johnson DS
; Weiner DE
J Am Soc Nephrol
2016[Jun]; 27
(6
): 1801-10
PMID26677862
show ga
Locally produced 1,25-dihydroxyvitamin D3 may have pleiotropic effects outside of
bone. Experimental and observational studies suggest that nutritional vitamin D
may enhance erythropoiesis in settings of 25-hydroxy vitamin D (25(OH)D)
deficiency. We conducted a double-blind, placebo-controlled, randomized clinical
trial to assess the effects of supplementation with ergocalciferol on epoetin
utilization and other secondary outcomes in patients on hemodialysis with serum
25(OH)D <30 ng/ml. In all, 276 patients were randomized to 6 months of
ergocalciferol or placebo. Mean±SD serum 25(OH)D increased from 16.0±5.9 ng/ml at
baseline to 39.2±14.9 ng/ml in the ergocalciferol arm and did not change
(16.9±6.4 ng/ml and 17.5±7.4 ng/ml, respectively) in the placebo arm. There was
no significant change in epoetin dose over 6 months in the ergocalciferol or
placebo arms (geometric mean rate 0.98 [95% confidence interval (95% CI), 0.94 to
1.02] versus 0.99 [95% CI, 0.95 to 1.03], respectively) and no difference across
arms (P=0.78). No change occurred in serum calcium, phosphorus, intact
parathyroid hormone, or C-reactive protein levels, cinacalcet use, or phosphate
binder or calcitriol dose in either study arm. Rates of all-cause,
cardiovascular, and infection-related hospitalizations did not differ by study
arm, although statistical power was limited for these outcomes. In conclusion, 6
months of supplementation with ergocalciferol increased serum 25(OH)D levels in
patients on hemodialysis with vitamin D insufficiency or deficiency, but had no
effect on epoetin utilization or secondary biochemical and clinical outcomes.